Healthcare Provider Details

I. General information

NPI: 1225778269
Provider Name (Legal Business Name): SHARI GRABER RN, DON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 S LEWIS RD
CAMARILLO CA
93012-8520
US

IV. Provider business mailing address

1750 S LEWIS RD
CAMARILLO CA
93012-8520
US

V. Phone/Fax

Practice location:
  • Phone: 805-702-2930
  • Fax:
Mailing address:
  • Phone: 805-702-2930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number630188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: